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Principles > Ch 18 Urinary System & Venipuncture > Flashcards

Ch 18 Urinary System & Venipuncture Flashcards

1
Q

the urinary system includes:

A

2 kidneys, 2 ureters, a urinary bladder, and a urethra

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2
Q

functions of the kidneys include:

A

removing waste products from the blood, maintaining fluid and electrolyte balance, and secreting substances that affect BP and other body functions

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3
Q

urine is expelled from the body via the:

A

excretory system (aka urinary system)

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4
Q

kidneys are what shape?

A

bean-shaped

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5
Q

the lateral border is ____ and the medial border is ____

A

convex, concave

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6
Q

each kidney is divided into:

A

upper and lower poles

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7
Q

the kidney is _____ long
_____ wide
_____ thick

A

4.5” long
2-3” wide
1.25” thick

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8
Q

the left kidney is usually:

A

slightly longer and narrower than the right

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9
Q

the kidneys are situated:

A

behind the peritoneum (retroperitoneal) and are in contact with the posterior abdominal wall

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10
Q

in reference to the spine the kidneys lie:

A

one on each side and on the same coronal plane as L3

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11
Q

the superior aspect of the kidney is:

A

more posterior than the inferior aspect

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12
Q

each kidney lies in a ____ plane and is rotated ____

A

oblique plane, rotated about 30 degrees anteriorly toward to aorta

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13
Q

the kidneys normally extend from:

A

the level of the superior aspect of T12 to the transverse processes of L3

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14
Q

the right kidney is ______ than the left

A

slightly lower (because of the liver)

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15
Q

the renal capsule is the:

A

outer covering of the kidney

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16
Q

each kidney is embedded in a mass of:

A

fatty tissue called the adipose capsule

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17
Q

each kidney has an outer ____ and an inner ____

A

renal cortex, renal medulla

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18
Q

the renal medulla contains:

A

renal pyramids

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19
Q

the renal cortex has extensions called:

A

renal columns

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20
Q

each kidney contains about 1 million:

A

nephrons

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21
Q

an individual nephron is composed of a:

A

renal corpuscle and a renal tubule

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22
Q

the renal corpuscle consists of a:

A

double walled membranous cup called the glomerular capsule (Bowman’s capsule) and a cluster of blood capillaries called glomerulus

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23
Q

the glomerulus is formed by:

A

a branch of the renal artery entering the capsule and dividing into capillaries that unite to form a single vessel leaving the capsule

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24
Q

afferent arteriole:

A

entering

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25
Q

efferent arteriole:

A

exiting

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26
Q

the glomerulus serves as a:

A

filter for the blood

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27
Q

the distal convoluted tubule open into the:

A

collecting ducts

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28
Q

calyces:

A

cup-shaped stems arising at the sides of the papilla of each renal pyramid

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29
Q

there are usually fewer ____ than _____

A

fewer calyces than pyramids

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30
Q

the major calyces unite to form:

A

the expanded, funnel-shaped renal pelvis

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31
Q

the renal pelvis becomes:

A

continuous with the ureter

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32
Q

each ureter is _____ long

A

10-12 inches long

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33
Q

the ureters enter the:

A

posterolateral surface of the urinary bladder

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34
Q

the ureters convey the urine from:

A

the renal pelves to the bladder by slow, rhythmic peristaltic contractions

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35
Q

the urinary bladder is a:

A

musculomembranous sac that serves as a reservoir for urine

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36
Q

the bladder is situated:

A

immediately posterior and superior to the pubic symphysis

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37
Q

the bladder in males is:

A

anterior to the rectum

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38
Q

the bladder in females is:

A

anterior to the vaginal canal

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39
Q

the apex of the bladder is:

A

anterior

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40
Q

trigone:

A

is the triangular area between the three orifices of the bladder

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41
Q

the urethra does what?

A

conveys urine out of the body

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42
Q

the urethra extends ___ in females and ____ in males

A

1.5” in females and 7-8” in males

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43
Q

the prostate is a:

A

small glandular body surrounding the proximal part of the male urethra

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44
Q

the prostate is considered:

A

part of the male reproductive system

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45
Q

the prostate measures ____ transversely
____ anterposteriorly at its base
___ vertically

A

1.5” transversely
.75” anteroposteriorly at its base
1” vertically

46
Q

in preparing to administer drugs the technologist should:

A

follow the 5 rights

47
Q

the 5 rights are:

A 
right patient
right drug
right amount
right time
right route
48
Q

to ensure that they right drug is given:

A

check the label on the container 3 times and the name

49
Q

you should always check the _____

A

expiration date

50
Q

routes are:

A

oral - by mouth
sublingual - under the tongue
topical - on the skin
parental - IV

51
Q

mild symptoms of adverse reactions to iodinated contrast are:

A

nausea, vomiting, cough, sneezing, flushing, dizziness, anxiety, metallic taste, a few hives or rash, slight swelling of the eyes/face

52
Q

moderate symptoms of adverse reactions to iodinated contrast are:

A

pulse change, hypotension, hypertension, dyspnea, bronchospasm, laryngospasm, hives, facial edema

53
Q

severe symptoms of adverse reactions to iodinated contrast are:

A

unresponsiveness, convulsions, arrhythmia’s, cardiopulmonary arrest, cyanosis, pulmonary edema, shock, renal failure

54
Q

the most important thing to do before administration of water-soluble iodine contrast media is:

A

patient history

55
Q

factors found in patient history that are factors in administering contrast media:

A

age, allergies, asthma, diabetes, coronary heart disease, hypertension, renal disease, multiple myeloma, sickle cell anemia, history of blood clots or COPD, previous iodine contrast use, pregnancy

56
Q

scheduling protocol for patients:

why do they have priority for contrast media exams?

A
  1. elderly
  2. diabetic
  3. children
  4. adults

because they are NPO (no food)

57
Q

priority order of multiple exams:

A
  1. x-ray
  2. nuc med (IVP)
  3. urinary
  4. barium/biliary
  5. lower bowel (BE)
  6. upper GI/small intestine
  7. bronchography/lymphography
58
Q

nonionic contrast media has osmolality which is:

A

a measure of the total number of particles in a solution per kilogram of water; how easily it dissolves in liquid

59
Q

lower osmolality is more _____ and less likely to _____

A

more water soluble and less likely to be reactive with allergic effects

60
Q

barium contrast is contraindicated when:

A

there is suspected perforation (don’t use barium when checking for leakage in GI bands)

61
Q

viscosity is _____; the friction of the media influences ____

A

the thickness of the media; the friction of the media influences the inject ability or delivery of the media

62
Q

what is a way to do a faster injection?

A

heating the media to body temperature

63
Q

________ plays a major part in the side effects; the ____ you inject the ______

A

the speed of injection; the faster you inject the more likely you will have side effects

64
Q

tomography:

A

uses motion to show anatomic structures lying in a selected plane of pre-determined thickness, by blurring the images of structures above and below the plane of interest

65
Q

the ___ and the ____ are moving while the ____ is still

A

the tube and IR are moving while the patient is still

66
Q

as exposure angle increases, section ___ decreases

A

as exposure angle increases, section thickness decreases

67
Q

in most IVP’s you want “____” cuts

A

“thin” cuts (30-40°) requiring 3 or 4 different slices to visualize the whole kidney

68
Q

the thinner the slice the _____

A

more detail for small parts

69
Q

exposure arc is:

A

the angle (in degrees) which you will make your tube move

70
Q

use (high/low) concentrations for bladder

A

low

71
Q

use (high/low) concentrations for excretory urograms

A

high

72
Q

adverse reactions to iodinated media are usually ____;

common reactions are:

A

mild and of short duration;

feeling warm, flushing, occasionally nausea, vomiting, and a few hives

73
Q

preparation for intestinal wall includes:

bowel preparation is not attempted in:

A

NPO, intestinal tract free of gas and solid fecal material

not attempted in infants or children and depends on the condition of the adult patient

74
Q

in preparation for retrograde urography have the patient:

A

drink 4-5 cups several hours before the examination

75
Q

excretory urographic studies require a ____ marker

A

a time interval marker for each post injection study

76
Q

urograms should show what anatomic structures?

A

outline of kidneys, lower border of liver, and lateral margin of the psoas muscle

77
Q

immobilization band is usually not applied over the upper abdomen in a urogram because?

A

the pressure may interfere with the passage of fluid through the ureters and mat cause distortion of the canals

78
Q

in excretory urography compression is sometimes applied over the distal end of the ureters why?

where on the body is the pressure applied?

A

to retard the flow of the opacified urine into the bladder and ensure adequate filling of the renal pelves and calyces

centered at the level of the ASIS

79
Q

compression is contraindicated if the patient has:

A

urinary stones, an abdominal mass or aneurysm, a colostomy, a suprapubic catheter, traumatic injury, or recent abdominal surgery

80
Q

all urogram use what respiration?

A

expiration because of he normal respiratory excursion, unless otherwise requested with appropriate marker

81
Q

an abdomen x-ray is made before a specialized investigation of the urinary tract to:

A

reveal any extra renal lesions that are responsible for the symptoms and render the investigation unnecessary

82
Q

a scout (recumbent) shows:

A

the contour of the kidneys, their location in the supine position, and the presence of renal calculi or calcifications; also to check preparation of the GI tract, check positioning, and to allow the tech to alter techniques

83
Q

can males be shielded for a urogram?

A

yes, except for the examinations of the urethra

84
Q

can females be shielded for a urogram?

A

only when the IR is centered over the kidneys - shield is placed over the pelvis

85
Q

IVU shows:

A

the function and structure of the urinary system

86
Q

urolithiasis is:

A

stones of kidney or urinary tract

87
Q

pyelonephritis is:

A

infection of the upper urinary tract

88
Q

hydronephrosis is:

A

abnormal dilation of the pelvicaliceal system

89
Q

normal creatine level is:

A

0.6-1.2 mg/100mL

90
Q

normal BUN level is:

A

8-25 mg/100mL

91
Q

elevated creatine or BUN levels indicate:

A

renal dysfunction

92
Q

the initial contrast “blush” of the kidney is termed the:

A

nephrogram phase

93
Q

the greatest concentration of contrast medium in the kidneys normally occurs:

A

15-20 minutes after injection

94
Q

most commonly recommended radiographs for IVU are __ projections at time intervals ranging from ______

A

AP projections ranging from 3-20 minutes

95
Q

AP oblique projections may be taken at ___ degrees at ___ intervals

A

30° at 5-10 minute intervals

96
Q

postvoid radiographs may be taken to detect?

A

presence of residual urine, small tumors, or enlargement of the prostate gland

97
Q

for abdomen you want (long/short) contrast?

A

long (grays)

98
Q

AP projection of the urinary system

SID:
patient position:
IR: 
CR:
respiration:
A

SID: 40”
patient position: supine, support under the knees, center MSP, arms out of the way
IR: centered at the level of the iliac crests
CR: perp. to level of iliac crests
respiration: suspend on expiration

99
Q

when contrast is introduced in the urinary system it becomes (long/short) scale

A

short (more B+W)

100
Q

AP projection of urinary system should show:

A

kidneys, ureters & bladder filled w/contrast, entire renal outline, pubic symphysis, and a time marker

101
Q

AP Oblique projection of the urinary system

SID: 
patient position:
IR:
CR:
respiration:
A

SID: 40”
patient position: from supine turn patient so that MCP is at an angle of 30° from the IR, shoulders and hips in same plane, arms out of the way
IR: centered at the level of the iliac crests
CR: perp. entering at level of iliac crests and 2” lateral to the midline of the elevated side
respiration: suspend on expiration

102
Q

AP Oblique projection of the urinary system should show:

A

30° rotation, both kidneys, no superimposition of the vertebrae, the bladder and lower ureters if they fit, and time marker

103
Q

in the AP Oblique projection of the urinary system the kidney closest to the IR is _____, the kidney farthest from the IR is ______

A

closest is perp. to IR

farthest is parallel with IR

104
Q

Lateral projection of the urinary system

SID:
patient position:
IR:
CR:
respiration:
A

SID: 40”
patient position: lateral recumbent, R or L position, flex knees, MCP is centered to midline, flex elbows and place hands under head
IR: centered at level of iliac crests
CR: perp. entering MCP at level of iliac crests
respiration: suspend on expiration

105
Q

Lateral projection of the urinary system shows:

is used to show what conditions?

A

kidney, ureters, and bladder filled with contrast

used to show rotation or pressure displacement of a kidneys and to localize calcareous areas and tumor masses

106
Q

nephrotomography is used to show what?

A

the renal parenchyma (nephrons and collecting tubes) immediately after introduction of contrast media

107
Q

nephrotomography is used to evaluate indications of:

A

renal hypertension, renal cysts, and renal tumors

108
Q

nephrotomography is contraindicated by:

A

renal failure or contrast media allergies/sensitivity

109
Q

retrograde urography requires:

A

the ureters to be catheterized so contrast can be injected directly into the pelvicaliceal system

110
Q

in the oblique position the lower kidney is _____ to the IR

A

perpendicular

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